| NPI | 1184876104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ELLISON-LACKARD Founder 347-995-5465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251S00000X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2018-07-05 |